Costochondritis: Causes, Symptoms, Diagnosis, and Treatment

Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone (sternum), specifically at the costosternal joints. It causes localized chest pain that can mimic heart-related conditions.

Symptoms

• Sharp, aching, or pressure-like pain on the front of the chest, usually on the left side
• Pain that worsens with deep breathing, coughing, sneezing, or physical activity
• Tenderness when pressing on the affected rib joints
• Pain may radiate to the back, shoulders, or arms

Causes and Risk Factors

• Physical strain or injury (heavy lifting, strenuous exercise)
• Respiratory infections causing violent coughing
• Direct trauma to the chest
• Certain types of arthritis (rheumatoid arthritis, ankylosing spondylitis)
• Joint infections (rare)

Diagnosis

Diagnosis is primarily clinical, based on history and physical examination. The doctor will reproduce the pain by pressing on the costosternal joints. Tests such as ECG, chest X-ray, or blood work may be ordered to rule out heart attack, pneumonia, or other conditions.

Treatment

Costochondritis is usually self-limiting, resolving within weeks to months. Treatment focuses on symptom relief:

• Rest and avoidance of aggravating activities
• NSAIDs (ibuprofen, naproxen) for pain and inflammation
• Heat or cold therapy
• Gentle stretching exercises
• In persistent cases: corticosteroid injections or physical therapy

When to Seek Medical Attention

Seek immediate care if chest pain is accompanied by shortness of breath, dizziness, sweating, or pain radiating to the jaw or left arm, as these may indicate a heart attack.